Effective: 2020-01-01

Course Description

The course outline below was developed as part of a statewide standardization process.

General Course Purpose

The purpose of this course is to introduce the novice ALS student to the principles of entry-level advanced emergency medical care.

Course Prerequisites/Corequisites

Prerequisite: Current Virginia EMT and CPR certification as approved by the Virginia Office of EMS

Course Objectives

• The purpose of this course is to introduce the novice ALS student to the principles of entry-level advanced emergency medical care.
• Integrate complex knowledge of the anatomy and physiology of the airway, respiratory and circulatory systems to the practice of EMS.
• Apply comprehensive knowledge of the pathophysiology of respiration and perfusion to patient assessment and management.
• Use simple knowledge of the principles of the role of EMS during public health emergencies.
• Apply (to patient assessment and management) fundamental knowledge of the medications carried by AEMTs that may be administered to a patient during an emergency.
• Apply knowledge (fundamental depth, foundational breadth) of upper airway anatomy and physiology to patient assessment and management in order to assure a patent airway, adequate mechanical ventilation, and respiration for patients of all ages.
• Apply scene information and patient assessment findings (scene size-up, primary and secondary assessment, patient history, reassessment) to guide emergency management
• Apply fundamental knowledge to provide basic and selected advanced emergency care and transportation based on assessment findings for an acutely ill patient.
• Apply fundamental knowledge to provide basic and selected advanced emergency care and transportation based on assessment findings for a patient in shock, respiratory failure or arrest,
• Apply fundamental knowledge to provide basic and selected advanced emergency care and transportation based on assessment findings for an acutely injured patient.
• Apply a fundamental knowledge of growth, development, aging, and assessment findings to provide basic and selected advanced emergency care and transportation for a patient with special needs.
• Demonstrate knowledge of operational roles and responsibilities to ensure patient, public, and personnel safety.

Major Topics to be Included

• EMS Systems
• Quality Improvement
• Patient safety
• Education
• Authorization to practice
• Integration with other professionals and continuity of care
• Maintenance of certification and licensure
• Role in public health
• Documentation
• Principles of medical documentation
• Concepts of report writing
• Special situations/reports/incident reporting
• EMS Communications
• Ems communication system
• Communicating with other health care professionals
• System maintenance
• phone/cellular communications
• Team communication and dynamics (crew resource management)
• Therapeutic communication
• Anatomy and Physiology
• Anatomy and body functions
• Life support chain
• Age-related variations for pediatrics and geriatrics
• Pathophysiology
• Introduction
• Basic cellular review
• Alteration in cells and tissues
• Cellular injury
• Hypoperfusion
• Principles of Pharmacology
• Medication safety
• Medication legislation
• Naming
• Classifications
• Storage and security
• Drug terminology
• Pharmacological concepts
• Medication Administration
• Routes of administration
• Administration of medication to a patient
• Concepts of safety
• Special considerations in pediatrics and geriatrics
• Specific Emergency medications
• Albuterol
• Aspirin
• Dextrose 50%
• Epinephrine (Intramuscular or Subcutaneous)
• Glucagon
• Glucose
• Intravenous Fluids
• Naloxone
• Nitroglycerin
• Oxygen
• Nitrous Oxide
• Airway Management
• Review of airway anatomy
• Airway assessment
• Techniques of assuring a patent airway
• Consider age-related variations in pediatric and geriatric patients
• Respiration and Ventilation
• Review of anatomy and physiology of the respiratory system
• Assessment of adequate and inadequate respiration
• Management of adequate and inadequate respiration
• Supplemental oxygen therapy
• Age-related variations in pediatric and geriatric patients
• Artificial ventilation
• The differences between normal and positive pressure ventilation
• Patient Assessment
• Primary assessment
• Components of patient assessment
• Primary survey/primary assessment
• Integration of treatment/procedures needed to preserve life
• Evaluating priority of patient care and transport
• Secondary Assessment
• Reassessment
• Monitoring Devices
• Medical Complaints Related to Neurology
• Stroke/tia
• Seizures
• Headache
• Age-related variations for pediatric and geriatric assessment and management
• Communication and documentation
• Transport decisions' rapid transport to appropriate facility
• Medical Complaints Related to Abdominal and Gastrointestinal Disorders
• Define Acute Abdomen
• Review of anatomy of the Organs of the Abdominopelvic Cavity
• Acute and Chronic Gastrointestinal Hemorrhage
• Peritonitis
• Ulcerative Diseases
• Immunology
• Basic immune system's response to allergens
• Pathophysiology of allergic reactions
• Differentiate between allergic reaction and anaphylaxis
• Managing anaphylaxis
• Age-related considerations
• Infectious Disease
• Causes of infectious disease
• Standard precautions, personal protective equipment, and cleaning and disposing of equipment
• Specific diseases and conditions
• Consider age-related variations in pediatric and geriatric patients as they relate assessment and managements of patients with a gastrointestinal condition or emergency
• Communication and documentation for a patient with a communicable or infectious disease
• Transport decisions including special infection control procedures
• Legal requirements regarding reporting communicable or infectious diseases/condition
• Medical Complaints Related to Endocrine Disorders
• Diabetic emergencies
• Other issues related to the endocrine system
• Age-related considerations
• Medical Complaints Related to Psychiatric Disorders
• Abnormal behavior
• Epidemiology of psychiatric disorders
• Assessment of the psychiatric patient
• Behavioral changes
• Psychiatric emergencies
• Medical-legal considerations
• Medical Complaints Related to Cardiovascular
• Review of the anatomy and physiology of the cardiovascular system
• Angina pectoris/acute coronary syndrome
• Acute myocardial infarction
• Toxicology
• Introduction to toxicology
• Poisoning by ingestion
• Poisoning by inhalation
• Poisoning by injection
• Poisoning by absorption
• Drugs of abuse
• Poisonings and exposures
• Medication overdose
• General treatment modalities for poisonings
• Toxic syndromes
• Medical Complaints Related to Respiratory
• Review of the anatomy and physiology of the pulmonary system
• Pathophysiology
• Assessment of a patient with a respiratory complaint
• Treatment of a patient with a respiratory complaint
• Hematology
• Epidemiology of blood disorders
• Sickle cell disease
• Management of blood related disorders
• Genitourinary/Renal Systems
• Review of the Anatomy and Physiology of the urinary system
• Dialysis patients
• Management of genitourinary disorders
• Shock and Resuscitation
• Ethical Issues in Resuscitation
• Cardiac Arrest and Resuscitation
• Automated External Defibrillation (AED) -- (Refer to Current AHA Guidelines)
• Advanced Life Support - Refer to the Current American Heart Association Guidelines
• Post-Resuscitation Support - Refer to the Current American Heart Association Guidelines
• Types of Shock
• Assessment and management of the patient suffering from shock
• Bleeding
• Fluid Resuscitation in Bleeding and Shock
• Chest Trauma
• Traumatic aortic disruption
• Pulmonary contusion
• Blunt cardiac injury
• Hemothorax
• Pneumothorax
• Cardiac tamponade
• Rib fractures
• Flail chest
• Commotio cordis
• General assessment and management
• Abdominal and Genitourinary Trauma
• Closed Abdominal Trauma
• Penetrating/Open Abdominal
• Considerations in Abdominal Trauma
• General assessment and management
• Sexual Assault
• Vaginal Bleeding Due to Trauma
• General assessment and management
• Orthopedic Trauma
• Amputations
• Pelvic Fractures
• Compartment Syndrome
• General assessment and management
• Soft Tissue Trauma
• Closed soft tissue injury
• Open soft tissue injury
• Anatomy and physiology of burns
• Complications of burn injuries
• Specific burn injury management considerations
• General assessment and management
• Head, Face and Neck Trauma
• Facial fractures
• Laryngeotracheal injuries
• Injuries to the eye
• Injuries to the ear
• Injuries to the neck
• General assessment and management
• Nervous System Trauma
• Traumatic brain injury
• Spinal cord injuries
• General assessment and management
• Special Considerations in Trauma
• Trauma in pregnancy
• Pediatric trauma
• Geriatric trauma
• Cognitively impaired patient trauma
• General assessment and management
• Multisystem Trauma
• Kinematics of trauma
• Multi-system trauma
• Blast injuries
• General assessment and management
• Special Populations
• Fluid resuscitation in the elderly
• Abuse and neglect
• Homelessness/poverty
• Bariatric patients
• Technology assisted/dependent
• Hospice care and terminally ill
• Tracheostomy care
• Sensory deficits
• Homecare
• Patient with developmental disability
• EMS Operations
• Safe air medical operations
• Safe vehicle extrication
• Hazardous materials
• Specialized types of rescue
• Use of simple hand tools
• Special considerations for patient care